Abstract:
BACKGROUND : Anti-human leukocyte antigen antibodies (anti-HLA) play a crucial role in graft. Detection of anti-HLA, both
pre- and post-transplant is a crucial investigation in clinical organ transplantation.
OBJECTIVES : Three methodologies for the detection of lymphocytotoxic antibodies were compared to establish which of
these is best suited to optimise pre-transplant donor-recipient matching.
METHODS : Serum samples from 15 renal transplant patients were tested for the presence of anti-HLA by i) cytotoxic-dependent
cross-match (CDCXM), ii) flow cytometric cross-match (FCXM) and iii) Luminex-based donor specific antibody
cross-match (DSAXM) method, Confirmatory tests for the presence of preformed HLA antibodies were tested using Luminex
methodology.
RESULTS : Two (13%) of the 15 patients had positive HLA Class I antibodies (Ab) using all 3 methods. An additional 2 HLA
Class I Ab were identified with FCXM/CDCXM. DSAXM identified 1 HLA Class I positive, not indicated by CDCXM/
FCXM.
High HLA Class II positivity (40%), identified by CDCXM, while DSAXM and FCXM identified two and one patients,
respectively. CDCXM produced 4 false-positive results confirmed by lymphocyte single antigen (LSA) assay.
CONCLUSIONS : The DSAXM method appears to add value in pre-transplantation screening to identify pre-sensitised patients
that may not reject the donor graft due to the absence of donor-specific antibodies.
